NURS 317 Unit 7 Pharm Chapter 13 Flashcards

1
Q

A school-aged child has been prescribed albendazole 15 mg/kg/day PO in divided doses, b.i.d. The child weighs 66 lbs and is 3’11” tall. How many milligrams of albendazole should the nurse administer for each dose of treatment?
__________ mg

A

225mg

Rationale:It is necessary first to convert the cliente administer for each dose of t ÷ 2.2 = 30 kg. 15 mg × 30 kg = 450 mg per day. The drug is in two divided doses, and 450 mg ÷ 2 = 225 mg. The client’s height is not included in this calculation.

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2
Q

After administering ivermectin, when should the nurse expect it will reach peak levels?

A) 24 hours

B) 4 hours

C) 2 hours

D) 30 minutes

A

B) 4 hours

Rationale:Ivermectin reaches peak levels in 4 hours.

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3
Q

Schistosomes invade tissue.

A) FALSE

B) TRUE

A

B) TRUE

Rationale:Schistosomiasis is an infection with a blood fluke, or schistosome, carried by snails and is commonly seen in tropical countries where the snail is the intermediary in the life cycle of the worm. Larvae burrow into the skin in fresh water and migrate throughout the human body, causing a rash and then symptoms of diarrhea and liver and brain inflammation.

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4
Q

A client who has had no previous contact with the healthcare system presents with elephantiasis of the lower legs. What helminthic infection should the nurse suspect?

A) Whipworm infection

B) Pinworm infection

C) Filariasis

D) Schistosomiasis

A

C) Filariasis

Rationale:Filariasis is associated with severe swelling of the hands, feet, legs, arms, scrotum, or breast, which is known as elephantiasis. Schistosomiasis is associated with a pruritic rash (swimmer’s itch). Whipworm infection is associated with colic and bloody diarrhea. Pinworm infection is associated with perianal itching.

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5
Q

What helminths should the nurse classify as nematodes? Select all that apply.

A) Platyhelminth

B) Threadworm

C) Schistosomiasis

D) Whipworm

E) Pinworm

A

B) Threadworm
D) Whipworm
E) Pinworm

Rationale:Nematodes are roundworms such as pinworms, whipworms, threadworms, Ascaris, or hookworms. A platyhelminth is a flatworm, while schistosomiasis results from a blood fluke carried by a snail.

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6
Q

Which complication of a client’s helminthic infection should lead the nurse to suspect that the client has a threadworm infection?

A) Anemia

B) Bloody diarrhea

C) Fever

D) Pneumonia

A

D) Pneumonia

Rationale:Pneumonia would be associated with a threadworm infection. Bloody diarrhea is associated with a whipworm infection. Anemia is associated with hookworm infections. Fever is not specific to threadworm infections

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7
Q

The nurse is caring for a client with a severe whipworm infection. Which of the nurse’s assessment findings would suggest complications of this helminthic infection?

A) Apathy and depression

B) Drowsiness and shortness of breath

C) Pallor and activity intolerance

D) Alopecia and fatigue

A

C) Pallor and activity intolerance

Rationale:Whipworms attach to the intestinal mucosa and suck blood, which can result in severe anemia and disintegration of the intestinal mucosa. None of the other listed findings is a known complication of whipworm infection.

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8
Q

A client is traumatized because the cestode that has been the cause of his or her helminthic infection has begun exiting the mouth. The client’s nurse should be aware that the client likely has what diagnosis?

A) Schistosomiasis

B) Tapeworm

C) Whipworm

D) Trichinosis

A

B) Tapeworm

Rationale:Tapeworm is a cestode, which can exit the nose or mouth. Trichinosis is a disease due to ingestion of a roundworm. Schistosomiasis is due to a platyhelminth or fluke. Whipworm is caused by a nematode or roundworm.

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9
Q

A client is suspected of having a helminthic infection. When reviewing the client’s history, what information may lead the nurse to suspect that the client has a tapeworm infection?

A) Eating unwashed vegetables

B) Recent wilderness camping

C) Consumption of sushi

D) Swimming in a fresh water lake

A

C) Consumption of sushi

Rationale:Tapeworms or cestodes enter the body as larvae that are found in undercooked fish or meat. Camping would not be a risk factor, since insect bites or dirt water are not causative factors. Ascaris occurs when a person ingests unwashed vegetables or other improperly washed foods grown in soil that contains roundworm eggs. Schistosomiasis occurs when a person swims in a fresh water pond or lake that has been contaminated with snail larvae.

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10
Q

A client is diagnosed with a threadworm infection. The nurse should anticipate administering what medication?

A) Praziquantel

B) Ivermectin

C) Mebendazole

D) Pyrantel

A

B) Ivermectin

Rationale:Ivermectin treats threadworm infections, which are also referred to as strongyloidiasis. Mebendazole is indicated for treatment of diseases cause by pinworms, roundworms, whipworms, and hookworms. Praziquantel is used for the treatment of schistosomes or flukes. Pyrantel is used to treat diseases caused by pinworms and roundworms.

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11
Q

The nurse has cared for several clients with helminthic infections over the past several months. What client would have required the closest monitoring for adverse effects of drug therapy?

A) A client who has a pork tapeworm and who is receiving albendazole

B) A pediatric client taking mebendazole for the treatment of hookworms

C) A client being treated with mebendazole for the treatment of roundworms

D) A client prescribed pyrantel for pinworm treatment

A

A) A client who has a pork tapeworm and who is receiving albendazole

Rationale:Mebendazole and pyrantel are generally well tolerated with comparatively few adverse effects. Renal failure and severe bone marrow depression are associated with albendazole, however, which is toxic to some human tissues. Patients taking this drug require careful monitoring.

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12
Q

When interviewing a client with a suspected worm infection, what assessment finding would best address the client’s risk of Ascaris?

A) “When was the last time that you ate pork?”

B) “Have you eaten any unwashed, fresh vegetables lately?”

C) “Have you been around mosquitoes the last few weeks?”

D) “Have you been swimming at all in the last few weeks?”

A

B) “Have you eaten any unwashed, fresh vegetables lately?”

Rationale:Consuming unwashed vegetables can lead to Ascaris. Ingestion of undercooked pork is associated with trichinosis. Swimming in contaminated water could lead schistosomiasis. A recent insect bite would be associated with filariasis or malaria.

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13
Q

Bone marrow suppression can occur with albendazole.

A) FALSE

B) TRUE

A

B) TRUE

Rationale:Bone marrow suppression can occur with albendazole, which is toxic to some human tissues. Patients taking this drug require careful monitoring.

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14
Q

A client can take an anthelmintic agent with food if GI upset occurs.

A) TRUE

B) FALSE

A

A) TRUE

Rationale:The nurse should provide anticipatory guidance that anthelmintics can cause GI upset and should be taken with food to reduce these effects.

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15
Q

A nurse is preparing to administer a client’s prescribed anthelmintic medication. What diagnostic results should provide the rationale for the team’s choice of medication?

A) Stool for ova and parasites

B) Stool for culture and sensitivity

C) Barium enema

D) Renal function studies

A

A) Stool for ova and parasites

Rationale:A stool culture specifically for ova and parasite is absolutely necessary for proper diagnosis and identification of the infecting worm. A routine stool culture looks for bacteria and would not identify the helminth involved. Renal function studies may be appropriate to establish a baseline, but they would not be as crucial as obtaining a stool culture for ova and parasite. This would not contribute to a diagnosis for a client with a suspected helminthic infection. A barium enema would not identify specific helminths.

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16
Q

A young adult client has been diagnosed with roundworms following the results of stool testing. The client states, “I’m absolutely mortified. I can’t even imagine anything more disgusting.” What should the nurse do when responding?

A) Reassure the client that treatment is usually rapid and effective.

B) Validate the client’s feelings without characterizing the diagnosis in the same way.

C) Express agreement and support for the client’s statement, as well as offering assistance.

D) Ask what the nurse can do to make the client feel better about the diagnosis.

A

B) Validate the client’s feelings without characterizing the diagnosis in the same way.

Rationale:The nurse should express empathy while making sure not to confirm that the situation is “disgusting.” Asking how the nurse can make the client feel better can come across as simplistic and does not validate the client’s feelings. Explaining the course of treatment does not address the client’s feelings.

17
Q

The nurse should prioritize which assessment data when caring for a client receiving albendazole therapy?

A) Orientation to person, place, and time

B) Blood urea nitrogen and creatinine levels

C) Skin integrity

D) Bowel pattern

A

B) Blood urea nitrogen and creatinine leve

Rationale:Albendazole can be toxic to some tissues such as the kidneys and bone marrow. Mebendazole and pyrantel, which are not absorbed systemically (which albendazole is), may cause abdominal discomfort, diarrhea, or pain. CNS effects such as headache and dizziness would be expected in a client receiving an anthelmintic agent that is absorbed systemically. Albendazole is poorly absorbed and would not create CNS effects.

18
Q

Anthelmintic agents can be used interchangeably to treat various worm infections.

A) FALSE

B) TRUE

A

A) FALSE

Rationale:Anthelmintic agents are very specific for the worms that they affect and are not interchangeable.

19
Q

A client is being treated on an acute medicine unit after being diagnosed with a tissue-invading helminthic infection. The helminth has affected the client’s muscles and lungs. What is the client’s most likely diagnosis?

A) Pinworm infection

B) Trichinosis

C) Ascaris

D) Threadworm infection

A

B) Trichinosis

Rationale:Trichinosis is a tissue-invading worm infection. Pinworm infection, threadworm infection, and Ascaris are intestine-invading worm infections.

20
Q

A nurse is speaking to a group of parents about pinworm infections. What priority teaching point should the nurse stress?

A) Thorough cooking of pork

B) Protection from insect bites

C) Avoidance of swimming in contaminated ponds

D) Meticulous handwashing

A

D) Meticulous handwashing

Rationale:Handwashing is essential in preventing the transmission and reinfection of pinworms. Insect bite protection would be appropriate to help prevent filariasis. Thoroughly cooking pork is appropriate for preventing the transmission of trichinosis. Avoiding swimming in contaminated bodies of water is appropriate for preventing the transmission of schistosomiasis.

21
Q

A client who is currently breast-feeding her 5-month-old infant has been diagnosed with pinworms. The nurse should anticipate what effect of breast-feeding on the client’s plan of care?

A) The client will be encouraged to stop breast-feeding while being treated with anthelmintics.

B) The client should be encouraged to wean her infant before beginning treatment.

C) The client can safely continue breast-feeding if mebendazole is prescribed.

D) The client can safely continue breast-feeding if pyrantel is prescribed.

A

A) The client will be encouraged to stop breast-feeding while being treated with anthelmintics.

Rationale:Because anthelmintic drugs can enter breast milk and could be toxic to the infant, women are advised to refrain from breast-feeding when using these drugs. This does not mean, however, that the client would necessarily need to wean her infant; breast-feeding could continue after the brief course of treatment and excretion of the drug.